No definite associations between opioid doses and severity of acute pancreatitis - Results from a multicentre international prospective study

Analgesics use and risk of pancreatitis: result from the UK Biobank

BACKGROUND

Pancreatitis, an inflammatory pancreatic disorder, arises from various etiologies including alcohol, tobacco, and drug use. Although the initiation of pancreatitis has been strongly linked to several medications, the association between analgesic use and pancreatitis risk remains ambiguous in population-based studies.

METHODS

This prospective cohort study involved 324,982 participants from the UK Biobank. Multivariable-adjusted Cox proportional-hazards models were conducted to evaluate the longitudinal association between incident pancreatitis risk and analgesics use, encompassing opioids, non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol, antimigraine preparations, and the mix. Subgroup and sensitivity analyses were conducted to assess the potential effects of baseline factors.

RESULTS

Over a median follow-up of 13.70 years, 2,303 cases of pancreatitis were identified. In the fully adjusted model, analgesics utilization increased the risk of pancreatitis (HR 1.13, 95% CI 1.04-1.23), acute pancreatitis (AP) (HR 1.11, 95% CI 1.01-1.22), and chronic pancreatitis (CP) (HR 1.25, 95% CI 1.00-1.56) (All the above p <0.05). Furthermore, participants who used opioids presented the highest risk of pancreatitis (HR 1.85, 95% CI 1.49-2.31, p <0.001), and the mixed group (HR 1.35, 95% CI 1.21-1.51, p <0.001) followed. Compared to the no analgesics group, the risk of both AP and CP also increased in the opioids and the mixed group. Subgroup analysis indicated that the impact of analgesics utilization on the pancreatitis risk may vary with certain covariates, such as age, cholelithiasis, etc. (p-interaction <0.05).

CONCLUSION

In this large population-based prospective cohort, analgesics utilization, particularly opioids and mixed analgesics, was linked to an increased risk of pancreatitis.